A nurse is planning care for a client who has a spinal cord injury and spasm-induced incontinence. Which of the following medications should the nurse anticipate a prescription for?

Choice A Reason:

Spinal cord injuries can disrupt the autonomic nervous system, impairing the body's ability to regulate temperature (thermoregulation). This can lead to temperature sensitivity, with clients experiencing issues such as difficulty sweating, shivering, or adapting to extreme temperatures.

Choice B Reason:

Contractures, which are the shortening and tightening of muscles, tendons, or ligaments, can occur as a complication of spinal cord injuries. Immobility and spasticity commonly seen in SCI can contribute to the development of contractures.

Choice C Reason:

Sexual dysfunction is a common complication of spinal cord injuries. SCI can affect sexual function and reproductive health due to changes in sensation, mobility, and autonomic nervous system function.

Choice D Reason:

Disc degeneration, or degenerative disc disease, typically occurs as a result of aging and wear and tear on the spinal discs. While SCI may lead to changes in spinal alignment and biomechanics, it is not a direct cause of disc degeneration.

Choice E Reason:

Urinary tract infections (UTIs) are a common complication of spinal cord injuries. Neurogenic bladder dysfunction, which is common in SCI, can lead to urinary retention, incomplete bladder emptying, and urinary stasis, increasing the risk of UTIs.

Choice A Reason:

Sedatives do not impact the risk of obstructive sleep apnea: This statement is incorrect. Sedatives, particularly those that cause muscle relaxation or depress the central nervous system, can exacerbate obstructive sleep apnea by further relaxing the muscles of the upper airway, leading to increased airway collapse during sleep.

Choice B Reason:

CPAP compliance enhances quality of sleep is correct. Continuous positive airway pressure (CPAP) therapy is a common treatment for obstructive sleep apnea. Compliance with CPAP therapy, meaning consistent and proper use of the CPAP device during sleep, is essential for effectively managing sleep apnea and improving sleep quality.

Choice C Reason:

Alcohol does not affect the risk of obstructive sleep apnea. This statement is incorrect. Alcohol consumption can worsen obstructive sleep apnea by promoting muscle relaxation in the upper airway, leading to increased airway collapse and more frequent episodes of apnea during sleep.

Choice D Reason:

Obesity increases the risk of obstructive sleep apnea. This statement is correct. Obesity is a significant risk factor for obstructive sleep apnea. Excess fat tissue around the neck can increase the likelihood of airway obstruction during sleep, contributing to the development or worsening of sleep apnea.

Choice E Reason:

Positional therapy enhances client comfort is correct. Positional therapy involves strategies to encourage sleeping in positions that minimize the severity of obstructive sleep apnea, particularly for individuals with positional OSA (where apnea events are primarily or significantly worse when sleeping in specific positions, such as supine). This statement is correct.

Choice F Reason:

Smoking increases the risk of obstructive sleep apnea: This statement is correct. Smoking can increase the risk of obstructive sleep apnea due to its effects on upper airway inflammation and respiratory function. Smoking cessation can be beneficial in managing sleep apnea and improving overall health.